1. Field of the Invention
This invention relates to surgical instruments for internal surgical use during laparoscopic surgery, and specifically to a laparoscopic surgical instrument that allows the surgeon to accurately provide manipulative movement of an internal organ, such as the uterus, while performing laparoscopic surgery or treatment on a patient.
2. Description of the Background Art
In recent years, laparoscopic examination and surgery has become one of the foremost procedures for improving internal organ surgery, resulting in improved, minimally invasive, techniques, less trauma to the patient during surgery, and much quicker recovery times after surgery.
Laparoscopic examination and surgery involves the insertion of a rigid tube in a small incision in the patient, the tube being called a trocar, which itself becomes the passageway for insertion of a cannula which includes one or more specialized instruments and/or visual examining devices. Thus, the introduction of various devices into the patient's body is facilitated by inserting an instrument containing cannula into a tubular trocar conduit that has been inserted into the patient's body. A number of instruments are known in the field of laparoscopic surgery; for example, visual examining devices, such as a TV camera, and also specific surgical tools, such as scissors and cauterizing devices, may be inserted into the patient for performing specific surgical procedures on various internal organs.
In certain laparoscopic procedures three cannulas are introduced into the patient through trocar conduits. A first cannula is typically used for visual examination, and allows the surgeon to view the inside organs of the patient, typically on a TV monitor. A second cannula would be used to introduce the actual surgical device, such as scissors or cauterizing device, as required. A third cannula may be utilized for additional surgical instruments necessary in performing the specific operation, or for introducing or draining fluid.
With respect to treatment of the uterus in surgical operations, it is often necessary or desirable for the surgeon to be able to move or manipulate portions of the uterus during the operation. Present day techniques involve the use of inserting instruments through the vagina and cervix into the uterus, such that the uterus is moved from within. This may require an extra person on the surgical team.
U.S. Pat. No. 4,430,076, issued Feb. 7, 1984 to Harris, shows a combined uterine injector and manipulative device, which includes an inflatable member at the insertable end that is inserted into the uterus. The device is secured in the uterus and enables the surgeon to manually position the uterus for examination purposes.
U.S. Pat. No. 5,362,294, issued Nov. 8, 1994 to Seitzinger, shows the use of a sling for positioning an internal organ during laparoscopic surgery. This is an elongated web having sutures on each end that actually allows the surgeon to manipulate an organ, such as the uterus, inside the patient, from outside the patient by pulling on the sutures. The apparatus disclosed by Seitzinger requires at least an additional person in the operating room to manipulate the sutures while the surgeon operates on the patient.
U.S. Pat. No. 5,217,466, issued Jun. 8, 1993 to Hasson, discloses a guide for facilitating the performance of internal surgery, such as laparoscopic surgery, which has a rotatable guide member that can be positioned within specific directions within an organ, such as the uterus. Hasson discloses an end tip which is curvable through manipulating manual devices, and the device provides for access through the uterine cavity to the fallopian tubes for purposes of intratubal insemination.
U.S. Pat. No. 5,431,662, issued Jul. 11, 1995 to Nicholas, shows a manually activated manipulator apparatus for manipulating a uterus for examination of the uterine cavity during a surgical procedure. While the manipulator apparatus shown is useful for laparoscopic surgery in procedures involving the uterus, the device is still introduced through the vagina and requires manipulation from within the uterus, through the use of the apparatus.
U.S. Pat. No. 5,464,409, issued Nov. 7, 1995 to Mohajer, shows a uterine manipulator and protector that again provides for manipulation of the uterus from within.
U.S. Pat. No. 5,237,985, issued Aug. 24, 1993 to Hodgson et al., shows a uterine retractor that accesses the uterus through the vaginal tract.
U.S. Pat. No. 5,571,115, issued Nov. 5, 1996 to Nicholas, provides for a manipulator apparatus that again is used to access the uterus through the vaginal tract from within.
U.S. Pat. No. 5,417,684, issued May 23, 1995 to Jackson et al., shows a laparoscopic surgical grasper with a loop with gripping formations. The loop is useful for holding and manipulating body organs and body tissue.
U.S. Pat. No. 5,490,819, issued Feb. 13, 1996 to Nicholas et al., shows an articulating endoscopic surgical apparatus. This device shows an endoscopic tool that includes a cooperating jaw.
None of the devices in the prior art show an effective laparoscopic tool that would allow the surgeon to manipulate the uterus by engagement of the exterior uterine wall during laparoscopic surgery. The invention may also be constructed in different sizes to be used on other organs such as an ovary, gall bladder or the like.